双环醇治疗严重银屑病患者药物性肝损伤的临床研究

摘要

Objective To evaluate the efficacy of bicyclol tablets in the treatment of drug-induced liver injury in patients with severe psoriasis.Methods 243 patients with with moderate to severe psoriasis and complicating drug-induced liver injury treated at our hospital from February,2015 to July,2016 were selected and were randomly divided into a bicyclol group (n=122) and a diammonium glycyrrhizinate group (n=121).The bicyclol group orally took bicyclol tablets and the diammonium glycyrrhizinate group diammonium glycyrrhizinate capsules for 8 weeks.The clinical symptoms and adverse reactions after medication were observed and recorded,the blood and urine routine examinations were taken,and liver and renal functions were detected in both groups.Results The levels of LT,TBIL,AST,and ALP were lower 4 weeks after than before the treatment in both groups,with statistical differences (all P ＜0.05).4 and 8 weeks after the treatment,the levels of ALT [(65.34±29.51)U/L vs.(90.29±32.27)U/L,P ＜ 0.05 and (37.20±15.91)U/L vs.(55.5±21.93)U/L,P ＜ 0.05]and AST [(71.42±35.92) U/L vs.(92.84±47.58) U/L,P ＜ 0.05 and (36.26±14.42) U/L vs.(56.30±28.35)U/L,P ＜ 0.05)] were significantly lower in the bicyclol group than in the diammonium glycyrrhizinate group,with statistical differences.8 weeks after the treatment,the efficacy was higher in the bicyclol group than in the diammonium glycyrrhizinate group (84.4％ vs.66.1％,P ＜0.001),with a statistical difference.Conclusions Bicyclol for drug-induced liver injury in patients with severe psoriasis is effective and safe,so it is worth being clinically generalized.%目的 评估双环醇片对严重银屑病患者服用药物所致肝损伤的疗效.方法 选取2015年2月至2016年7月在本院治疗的中重度银屑病并出现肝损害的患者共计243例.依据随机数字表法将患者随机分为两组,即双环醇组(n=122)与甘草酸二胺组(n=121).双环醇组患者口服双环醇片,甘草酸二铵组患者口服甘草酸二铵胶囊,治疗8周.对患者的临床症状与用药后不良反应进行观察记录,同时检测患者血尿常规与肝、肾功能.结果 两组患者肝功指标ALT、TBIL、AST、ALP在治疗4周后均显著降低,治疗前后比较差异均有统计学意义(均P＜ 0.05);双环醇组ALT[第4周:(65.34±29.51)U/L比(90.29±32.27) U/L,P＜0.05;第8周:(37.20±15.91) U/L比(55.5±21.93) U/L,P＜0.05]与AST[第4周:(71.42±35.92) U/L比(92.84±47.58) U/L,P＜0.05;第8周:(36.26±14.42)U/L比(56.30±28.35) U/L,P＜0.05)]指标在治疗第4周与第8周显著低于甘草酸二铵组,差异均有统计学意义;治疗8周后,双环醇组的有效率较甘草酸二铵组显著提高,差异有统计学意义(84.4％比66.1％,p＜0.001).结论 双环醇片对严重银屑病患者服用药物所致的肝损伤进行治疗,疗效好、安全性高,值得临床推广.